Metformin Use and Myeloprofilerative Neoplasms - EMJ

Metformin Use Linked to Lower Risk of Myeloproliferative Neoplasms

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A recent study published highlights a significant association between metformin use and a reduced risk of developing myeloproliferative neoplasms (MPNs), particularly the subtypes essential thrombocythemia (ET) and polycythaemia vera (PV). 

Metformin, a common medication for type 2 diabetes, has been previously noted for its potential benefits beyond glucose control, including antineoplastic and cancer-preventive properties. This study aimed to investigate the relationship between metformin use and MPN risk through a population-based case-control study using Danish registers. 

Researchers identified cases of MPN diagnosed between 2010–2018 and examined metformin use prior to diagnosis. They compared 3,816 MPN cases to 19,080 age- and sex-matched controls from the Danish general population. The findings revealed that 7.0% of MPN cases had used metformin compared to 8.2% of controls, resulting in an odds ratio (OR) of 0.84 (95% Confidence Interval [CI]: 0.73-0.96) and an adjusted OR (aOR) of 0.70 (95% CI: 0.61-0.81). 

Notably, long-term metformin use (≥5 years) was less common, observed in 1.1% of cases and 2.0% of controls. This corresponded to an OR of 0.57 (95% CI: 0.42-0.79) and an aOR of 0.45 (95% CI: 0.33-0.63), demonstrating a stronger protective effect with prolonged use. A clear dose-response relationship was identified, with increasing treatment duration correlating with decreased MPN risk. 

The protective association was consistent across different ages, sexes, and MPN subtypes, suggesting a robust link between metformin use and reduced MPN risk. However, due to the retrospective design of the study, causality cannot be definitively established. 

These findings support the potential cancer-preventive effects of metformin and underscore the need for further research to explore the mechanisms behind this association and its implications for long-term metformin use in preventing hematologic malignancies. 



Kristensen DT et al. Metformin use and risk of myeloproliferative neoplasms – a Danish population-based case-control study. Blood Advances. 2024 


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